Multi-layer surgical stapler buttress assembly

ABSTRACT

A surgical stapler end effector assembly includes a staple cartridge, an end effector, and a buttress assembly. The cartridge included a plurality of staples and a deck. The cartridge is operable to drive the staples through the deck. The anvil includes an underside having a staple forming surface configured to receive staples driven through the deck. The buttress assembly is sized and configured to be coupled with the deck of the staple cartridge or the underside of the anvil. The buttress assembly includes a buttress body, a first adhesive layer, and a second adhesive layer. The first and second adhesive layers are formed of different materials. The first adhesive layer is laid over the buttress body. The second adhesive layer is laid over the first adhesive layer such that the first adhesive layer is interposed between the second adhesive layer and the buttress body.

BACKGROUND

In some settings, endoscopic surgical instruments may be preferred overtraditional open surgical devices since a smaller incision may reducethe post-operative recovery time and complications. Consequently, someendoscopic surgical instruments may be suitable for placement of adistal end effector at a desired surgical site through the cannula of atrocar. These distal end effectors may engage tissue in a number of waysto achieve a diagnostic or therapeutic effect (e.g., endocutter,grasper, cutter, stapler, clip applier, access device, drug/gene therapydelivery device, and energy delivery device using ultrasonic vibration,RF, laser, etc.). Endoscopic surgical instruments may include a shaftbetween the end effector and a handle portion, which is manipulated bythe clinician. Such a shaft may enable insertion to a desired depth androtation about the longitudinal axis of the shaft, thereby facilitatingpositioning of the end effector within the patient. Positioning of anend effector may be further facilitated through inclusion of one or morearticulation joints or features, enabling the end effector to beselectively articulated or otherwise deflected relative to thelongitudinal axis of the shaft.

Examples of endoscopic surgical instruments include surgical staplers.Some such staplers are operable to clamp down on layers of tissue, cutthrough the clamped layers of tissue, and drive staples through thelayers of tissue to substantially seal the severed layers of tissuetogether near the severed ends of the tissue layers. Merely exemplarysurgical staplers are disclosed in U.S. Pat. No. 4,805,823, entitled“Pocket Configuration for Internal Organ Staplers,” issued Feb. 21,1989; U.S. Pat. No. 5,415,334, entitled “Surgical Stapler and StapleCartridge,” issued May 16, 1995; U.S. Pat. No. 5,465,895, entitled“Surgical Stapler Instrument,” issued Nov. 14, 1995; U.S. Pat. No.5,597,107, entitled “Surgical Stapler Instrument,” issued Jan. 28, 1997;U.S. Pat. No. 5,632,432, entitled “Surgical Instrument,” issued May 27,1997; U.S. Pat. No. 5,673,840, entitled “Surgical Instrument,” issuedOct. 7, 1997; U.S. Pat. No. 5,704,534, entitled “Articulation Assemblyfor Surgical Instruments,” issued Jan. 6, 1998; U.S. Pat. No. 5,814,055,entitled “Surgical Clamping Mechanism,” issued Sep. 29, 1998; U.S. Pat.No. 6,978,921, entitled “Surgical Stapling Instrument Incorporating anE-Beam Firing Mechanism,” issued Dec. 27, 2005; U.S. Pat. No. 7,000,818,entitled “Surgical Stapling Instrument Having Separate Distinct Closingand Firing Systems,” issued Feb. 21, 2006; U.S. Pat. No. 7,143,923,entitled “Surgical Stapling Instrument Having a Firing Lockout for anUnclosed Anvil,” issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitled“Surgical Stapling Instrument Incorporating a Multi-Stroke FiringMechanism with a Flexible Rack,” issued Dec. 4, 2007; U.S. Pat. No.7,367,485, entitled “Surgical Stapling Instrument Incorporating aMultistroke Firing Mechanism Having a Rotary Transmission,” issued May6, 2008; U.S. Pat. No. 7,380,695, entitled “Surgical Stapling InstrumentHaving a Single Lockout Mechanism for Prevention of Firing,” issued Jun.3, 2008; U.S. Pat. No. 7,380,696, entitled “Articulating SurgicalStapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism,”issued Jun. 3, 2008; U.S. Pat. No. 7,404,508, entitled “SurgicalStapling and Cutting Device,” issued Jul. 29, 2008; U.S. Pat. No.7,434,715, entitled “Surgical Stapling Instrument Having MultistrokeFiring with Opening Lockout,” issued Oct. 14, 2008; U.S. Pat. No.7,721,930, entitled “Disposable Cartridge with Adhesive for Use with aStapling Device,” issued May 25, 2010; U.S. Pat. No. 8,408,439, entitled“Surgical Stapling Instrument with An Articulatable End Effector,”issued Apr. 2, 2013; and U.S. Pat. No. 8,453,914, entitled “Motor-DrivenSurgical Cutting Instrument with Electric Actuator Directional ControlAssembly,” issued Jun. 4, 2013. The disclosure of each of theabove-cited U.S. patents is incorporated by reference herein.

While the surgical staplers referred to above are described as beingused in endoscopic procedures, it should be understood that suchsurgical staplers may also be used in open procedures and/or othernon-endoscopic procedures. By way of example only, a surgical staplermay be inserted through a thoracotomy, and thereby between a patient'sribs, to reach one or more organs in a thoracic surgical procedure thatdoes not use a trocar as a conduit for the stapler. Such procedures mayinclude the use of the stapler to sever and close a vessel leading to alung. For instance, the vessels leading to an organ may be severed andclosed by a stapler before removal of the organ from the thoraciccavity. Of course, surgical staplers may be used in various othersettings and procedures.

Examples of surgical staplers that may be particularly suited for usethrough a thoracotomy are disclosed in U.S. Patent Pub. No.2014/0243801, entitled “Surgical Instrument End Effector ArticulationDrive with Pinion and Opposing Racks,” published Aug. 28, 2014; U.S.Patent Pub. No. 2014/0239041, entitled “Lockout Feature for MovableCutting Member of Surgical Instrument,” published Aug. 28, 2014; U.S.Patent Pub. No. 2014/0239042, entitled “Integrated Tissue Positioningand Jaw Alignment Features for Surgical Stapler,” published Aug. 28,2014; U.S. Patent Pub. No. 2014/0239036, entitled “Jaw Closure Featurefor End Effector of Surgical Instrument,” published Aug. 28, 2014; U.S.Patent Pub. No. 2014/0239040, entitled “Surgical Instrument withArticulation Lock having a Detenting Binary Spring,” published Aug. 28,2014; U.S. Patent Pub. No. 2014/0239043, entitled “Distal Tip Featuresfor End Effector of Surgical Instrument,” published Aug. 28, 2014; U.S.Patent Pub. No. 2014/0239037, entitled “Staple Forming Features forSurgical Stapling Instrument,” published Aug. 28, 2014; U.S. Patent Pub.No. 2014/0239038, entitled “Surgical Instrument with Multi-DiameterShaft,” published Aug. 28, 2014; and U.S. Patent Pub. No. 2014/0239044,entitled “Installation Features for Surgical Instrument End EffectorCartridge,” published Aug. 28, 2014. The disclosure of each of theabove-cited U.S. Patent Publications is incorporated by referenceherein.

Additional surgical stapling instruments are disclosed in U.S. Pat. No.8,801,735, entitled “Surgical Circular Stapler with Tissue RetentionArrangements,” issued Aug. 12, 2014; U.S. Pat. No. 8,141,762, entitled“Surgical Stapler Comprising a Staple Pocket,” issued Mar. 27, 2012;U.S. Pat. No. 8,371,491, entitled “Surgical End Effector Having ButtressRetention Features,” issued Feb. 12, 2013; U.S. Pub. No. 2014/0263563,entitled “Method and Apparatus for Sealing End-to-End Anastomosis”published Sep. 18, 2014; U.S. Pub. No. 2014/0246473, entitled “RotaryPowered Surgical Instruments with Multiple Degrees of Freedom,”published Sep. 4, 2014; U.S. Pub. No. 2013/0206813, entitled “LinearStapler,” published Aug. 15, 2013; U.S. Pub. No. 2008/0169328, entitled“Buttress Material for Use with a Surgical Stapler,” published Jul. 17,2008; U.S. patent application Ser. No. 14/300,804, entitled “Woven andFibrous Materials for Reinforcing a Staple Line,” filed Jun. 10, 2014;U.S. patent application Ser. No. 14/300,811, entitled “Devices andMethods for Sealing Staples in Tissue”; and U.S. patent application Ser.No. 14/498,070, entitled “Radically Expandable Staple Line” filed Sep.26, 2014. The disclosure of each of the above-cited U.S. patents, U.S.Patent Publications, and U.S. patent applications is incorporated byreference herein.

In some instances, it may be desirable to equip a surgical staplinginstrument with a buttress material to reinforce the mechanicalfastening of tissue provided by staples. Such a buttress may prevent theapplied staples from pulling through tissue and may otherwise reduce arisk of tissue tearing at or near the site of applied staples.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain the principles of the present invention.

FIG. 1 depicts a perspective view of an exemplary articulating surgicalstapling instrument;

FIG. 2 depicts a perspective view of an end effector of the instrumentof FIG. 1, with the end effector in an open configuration;

FIG. 3 depicts an exploded perspective view of the end effector of FIG.2;

FIG. 4 depicts a perspective view of an exemplary upper buttress and anexemplary lower buttress, each of which may be applied to the endeffector of FIG. 2;

FIG. 5A depicts a cross-sectional end view of a portion of the endeffector of FIG. 2 with a buttress assembly formed by the buttresses ofFIG. 4 applied to the end effector, with tissue positioned between thebuttresses in the end effector, and with the anvil in an open position;

FIG. 5B depicts a cross-sectional end view of the combined end effectorand buttress assembly of FIG. 5A, with tissue positioned between thebuttresses in the end effector, and with the anvil in a closed position;

FIG. 5C depicts a cross-sectional view of a staple and the buttressassembly of FIG. 5A having been secured to the tissue by the endeffector of FIG. 2;

FIG. 6 depicts a perspective view of staples and the buttress assemblyof FIG. 5A having been secured to the tissue by the end effector of FIG.2;

FIG. 7 depicts a perspective view of an exemplary alternative buttress;

FIG. 8 depicts a cross-sectional end view of the buttress of FIG. 7;

FIG. 9 depicts a perspective view of another exemplary alternativebuttress; and

FIG. 10 depicts a cross-sectional end view of the buttress of FIG. 8.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the invention may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presentinvention, and together with the description serve to explain theprinciples of the invention; it being understood, however, that thisinvention is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the invention shouldnot be used to limit the scope of the present invention. Other examples,features, aspects, embodiments, and advantages of the invention willbecome apparent to those skilled in the art from the followingdescription, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsshould be regarded as illustrative in nature and not restrictive.

I. EXEMPLARY SURGICAL STAPLER

FIG. 1 depicts an exemplary surgical stapling and severing instrument(10) that includes a handle assembly (20), a shaft assembly (30), and anend effector (40). End effector (40) and the distal portion of shaftassembly (30) are sized for insertion, in a nonarticulated state asdepicted in FIG. 1, through a trocar cannula to a surgical site in apatient for performing a surgical procedure. By way of example only,such a trocar may be inserted in a patient's abdomen, between two of thepatient's ribs, or elsewhere. In some settings, instrument (10) is usedwithout a trocar. For instance, end effector (40) and the distal portionof shaft assembly (30) may be inserted directly through a thoracotomy orother type of incision. It should be understood that terms such as“proximal” and “distal” are used herein with reference to a cliniciangripping handle assembly (20) of instrument (10). Thus, end effector(40) is distal with respect to the more proximal handle assembly (20).It will be further appreciated that for convenience and clarity, spatialterms such as “vertical” and “horizontal” are used herein with respectto the drawings. However, surgical instruments are used in manyorientations and positions, and these terms are not intended to belimiting and absolute.

A. Exemplary Handle Assembly and Shaft Assembly

As shown in FIG. 1, handle assembly (20) of the present examplecomprises pistol grip (22), a closure trigger (24), and a firing trigger(26). Each trigger (24, 26) is selectively pivotable toward and awayfrom pistol grip (22) as will be described in greater detail below.Handle assembly (20) further includes a removable battery pack (28).These components will also be described in greater detail below. Ofcourse, handle assembly (20) may have a variety of other components,features, and operabilities, in addition to or in lieu of any of thosenoted above. Other suitable configurations for handle assembly (20) willbe apparent to those of ordinary skill in the art in view of theteachings herein.

As shown in FIGS. 1-2, shaft assembly (30) of the present examplecomprises an outer closure tube (32), an articulation section (34), anda closure ring (36), which is further coupled with end effector (40).Closure tube (32) extends along the length of shaft assembly (30).Closure ring (36) is positioned distal to articulation section (34).Closure tube (32) and closure ring (36) are configured to translatelongitudinally relative to handle assembly (20). Longitudinaltranslation of closure tube (32) is communicated to closure ring (36)via articulation section (34). Exemplary features that may be used toprovide longitudinal translation of closure tube (32) and closure ring(36) will be described in greater detail below.

Articulation section (34) is operable to laterally deflect closure ring(36) and end effector (40) laterally away from the longitudinal axis(LA) of shaft assembly (30) at a desired angle (a). In the presentexample, articulation is controlled through an articulation control knob(35) which is located at the proximal end of shaft assembly (30).Closure ring (36) and end effector (40) pivot about an axis that isperpendicular to the longitudinal axis (LA) of shaft assembly (30) inresponse to rotation of knob (35). Articulation section (34) isconfigured to communicate longitudinal translation of closure tube (32)to closure ring (36), regardless of whether articulation section (34) isin a straight configuration or an articulated configuration. By way ofexample only, articulation section (34) and/or articulation control knob(35) may be constructed and operable in accordance with at least some ofthe teachings of U.S. Pub. No. 2014/0243801, entitled “SurgicalInstrument End Effector Articulation Drive with Pinion and OpposingRacks,” published Aug. 28, 2014, the disclosure of which is incorporatedby reference herein; and/or U.S. patent application Ser. No. 14/314,125,entitled “Articulation Drive Features for Surgical Stapler,” filed Jun.25, 2014, the disclosure of which is incorporated by reference herein;and/or in accordance with the various teachings below. Other suitableforms that articulation section (34) and articulation knob (35) may takewill be apparent to those of ordinary skill in the art in view of theteachings herein.

As shown in FIG. 1, shaft assembly (30) of the present example furtherincludes a rotation knob (31). Rotation knob (31) is operable to rotatethe entire shaft assembly (30) and end effector (40) relative to handleassembly (20) about the longitudinal axis (LA) of shaft assembly (30).Of course, shaft assembly (30) may have a variety of other components,features, and operabilities, in addition to or in lieu of any of thosenoted above. By way of example only, at least part of shaft assembly(30) is constructed in accordance with at least some of the teachings ofU.S. Pub. No. 2014/0239038, entitled “Surgical Instrument withMulti-Diameter Shaft,” published Aug. 28, 2014, the disclosure of whichis incorporated by reference herein. Other suitable configurations forshaft assembly (30) will be apparent to those of ordinary skill in theart in view of the teachings herein.

B. Exemplary End Effector

As also shown in FIGS. 1-3, end effector (40) of the present exampleincludes a lower jaw (50) and a pivotable anvil (60). Anvil (60)includes a pair of integral, outwardly extending pins (66) that aredisposed in corresponding curved slots (54) of lower jaw (50). Anvil(60) is pivotable toward and away from lower jaw (50) between an openposition (shown in FIG. 2) and a closed position (shown in FIG. 1). Useof the term “pivotable” (and similar terms with “pivot” as a base)should not be read as necessarily requiring pivotal movement about afixed axis. For instance, in the present example, anvil (60) pivotsabout an axis that is defined by pins (66), which slide along curvedslots (54) of lower jaw (50) as anvil (60) moves toward lower jaw (50).In such versions, the pivot axis translates along the path defined byslots (54) while anvil (60) simultaneously pivots about that axis. Inaddition or in the alternative, the pivot axis may slide along slots(54) first, with anvil (60) then pivoting about the pivot axis after thepivot axis has slid a certain distance along the slots (54). It shouldbe understood that such sliding/translating pivotal movement isencompassed within terms such as “pivot,” “pivots,” “pivotal,”“pivotable,” “pivoting,” and the like. Of course, some versions mayprovide pivotal movement of anvil (60) about an axis that remains fixedand does not translate within a slot or channel, etc.

As best seen in FIG. 3, lower jaw (50) of the present example defines achannel (52) that is configured to receive a staple cartridge (70).Staple cartridge (70) may be inserted into channel (52), end effector(40) may be actuated, and then staple cartridge (70) may be removed andreplaced with another staple cartridge (70). Lower jaw (50) thusreleasably retains staple cartridge (70) in alignment with anvil (60)for actuation of end effector (40). In some versions, lower jaw (50) isconstructed in accordance with at least some of the teachings of U.S.Pub. No. 2014/0239044, entitled “Installation Features for SurgicalInstrument End Effector Cartridge,” published Aug. 28, 2014, thedisclosure of which is incorporated by reference herein. Other suitableforms that lower jaw (50) may take will be apparent to those of ordinaryskill in the art in view of the teachings herein.

As best seen in FIGS. 2-3, staple cartridge (70) of the present examplecomprises a cartridge body (71) and a tray (76) secured to the undersideof cartridge body (71). The upper side of cartridge body (71) presents adeck (73), against which tissue may be compressed when anvil (60) is ina closed position. Cartridge body (71) further defines a longitudinallyextending channel (72) and a plurality of staple pockets (74). A staple(90) is positioned in each staple pocket (74). A staple driver (75) isalso positioned in each staple pocket (74), underneath a correspondingstaple (90), and above tray (76). As will be described in greater detailbelow, staple drivers (75) are operable to translate upwardly in staplepockets (74) to thereby drive staples (90) upwardly through staplepockets (74) and into engagement with anvil (60). Staple drivers (75)are driven upwardly by a wedge sled (78), which is captured betweencartridge body (71) and tray (76), and which translates longitudinallythrough cartridge body (71).

Wedge sled (78) includes a pair of obliquely angled cam surfaces (79),which are configured to engage staple drivers (75) and thereby drivestaple drivers (75) upwardly as wedge sled (78) translateslongitudinally through cartridge (70). For instance, when wedge sled(78) is in a proximal position, staple drivers (75) are in downwardpositions and staples (90) are located in staple pockets (74). As wedgesled (78) is driven to the distal position by a translating knife member(80), wedge sled (78) drives staple drivers (75) upwardly, therebydriving staples (90) out of staple pockets (74) and into staple formingpockets (64) that are formed in the underside (65) of anvil (60). Thus,staple drivers (75) translate along a vertical dimension as wedge sled(78) translates along a horizontal dimension.

In some versions, staple cartridge (70) is constructed and operable inaccordance with at least some of the teachings of U. U.S. Pub. No.2014/0239042, entitled “Integrated Tissue Positioning and Jaw AlignmentFeatures for Surgical Stapler,” published Aug. 28, 2014, the disclosureof which is incorporated by reference herein. In addition or in thealternative, staple cartridge (70) may be constructed and operable inaccordance with at least some of the teachings of U.S. Pub. No.2014/0239044, entitled “Installation Features for Surgical InstrumentEnd Effector Cartridge,” published Aug. 28, 2014, the disclosure ofwhich is incorporated by reference herein. Other suitable forms thatstaple cartridge (70) may take will be apparent to those of ordinaryskill in the art in view of the teachings herein.

As best seen in FIG. 2, anvil (60) of the present example comprises alongitudinally extending channel (62) and a plurality of staple formingpockets (64). Channel (62) is configured to align with channel (72) ofstaple cartridge (70) when anvil (60) is in a closed position. Eachstaple forming pocket (64) is positioned to lie over a correspondingstaple pocket (74) of staple cartridge (70) when anvil (60) is in aclosed position. Staple forming pockets (64) are configured to deformthe legs of staples (90) when staples (90) are driven through tissue andinto anvil (60). In particular, staple forming pockets (64) areconfigured to bend the legs of staples (90) to secure the formed staples(90) in the tissue. Anvil (60) may be constructed in accordance with atleast some of the teachings of U.S. Pub. No. 2014/0239042, entitled“Integrated Tissue Positioning and Jaw Alignment Features for SurgicalStapler,” published Aug. 28, 2014; at least some of the teachings ofU.S. Pub. No. 2014/0239036, entitled “Jaw Closure Feature for EndEffector of Surgical Instrument,” published Aug. 28, 2014; and/or atleast some of the teachings of U.S. Pub. No. 2014/0239037, entitled“Staple Forming Features for Surgical Stapling Instrument,” publishedAug. 28, 2014, the disclosure of which is incorporated by referenceherein. Other suitable forms that anvil (60) may take will be apparentto those of ordinary skill in the art in view of the teachings herein.

In the present example, a knife member (80) is configured to translatethrough end effector (40). As best seen in FIG. 3, knife member (80) issecured to the distal end of a firing beam (82), which extends through aportion of shaft assembly (30). As best seen in FIG. 2, knife member(80) is positioned in channels (62, 72) of anvil (60) and staplecartridge (70). Knife member (80) includes a distally presented cuttingedge (84) that is configured to sever tissue that is compressed betweenanvil (60) and deck (73) of staple cartridge (70) as knife member (80)translates distally through end effector (40). As noted above, knifemember (80) also drives wedge sled (78) distally as knife member (80)translates distally through end effector (40), thereby driving staples(90) through tissue and against anvil (60) into formation.

C. Exemplary Actuation of End Effector

In the present example, anvil (60) is driven toward lower jaw (50) byadvancing closure ring (36) distally relative to end effector (40).Closure ring (36) cooperates with anvil (60) through a camming action todrive anvil (60) toward lower jaw (50) in response to distal translationof closure ring (36) relative to end effector (40). Similarly, closurering (36) may cooperate with anvil (60) to open anvil (60) away fromlower jaw (50) in response to proximal translation of closure ring (36)relative to end effector (40). By way of example only, closure ring (36)and anvil (60) may interact in accordance with at least some of theteachings of U.S. Pub. No. 2014/0239036, entitled “Jaw Closure Featurefor End Effector of Surgical Instrument,” published Aug. 28, 2014, thedisclosure of which is incorporated by reference herein; and/or inaccordance with at least some of the teachings of U.S. patentapplication Ser. No. 14/314,108, entitled “Jaw Opening Feature forSurgical Stapler,” filed on Jun. 25, 2014, the disclosure of which isincorporated by reference herein.

As noted above, handle assembly (20) includes a pistol grip (22) and aclosure trigger (24). As also noted above, anvil (60) is closed towardlower jaw (50) in response to distal advancement of closure ring (36).In the present example, closure trigger (24) is pivotable toward pistolgrip (22) to drive closure tube (32) and closure ring (36) distally.Various suitable components that may be used to convert pivotal movementof closure trigger (24) toward pistol grip (22) into distal translationof closure tube (32) and closure ring (36) relative to handle assembly(20) will be apparent to those of ordinary skill in the art in view ofthe teachings herein.

Also in the present example, instrument (10) provides motorized controlof firing beam (82). In particular, instrument (10) includes motorizedcomponents that are configured to drive firing beam (82) distally inresponse to pivoting of firing trigger (26) toward pistol grip (22). Insome versions, a motor (not shown) is contained in pistol grip (22) andreceives power from battery pack (28). This motor is coupled with atransmission assembly (not shown) that converts rotary motion of a driveshaft of the motor into linear translation of firing beam (82). By wayof example only, the features that are operable to provide motorizedactuation of firing beam (82) may be configured and operable inaccordance with at least some of the teachings of U.S. Pat. No.8,210,411, entitled “Motor-Driven Surgical Instrument,” issued Jul. 3,2012, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 8,453,914, entitled “Motor-Driven Surgical Cutting Instrumentwith Electric Actuator Directional Control Assembly,” issued Jun. 4,2013, the disclosure of which is incorporated by reference herein;and/or U.S. patent application Ser. No. 14/226,142, entitled “SurgicalInstrument Comprising a Sensor System,” filed Mar. 26, 2014, thedisclosure of which is incorporated by reference herein.

It should also be understood that any other components or features ofinstrument (10) may be configured and operable in accordance with any ofthe various references cited herein. Additional exemplary modificationsthat may be provided for instrument (10) will be described in greaterdetail below. Various suitable ways in which the below teachings may beincorporated into instrument (10) will be apparent to those of ordinaryskill in the art. Similarly, various suitable ways in which the belowteachings may be combined with various teachings of the references citedherein will be apparent to those of ordinary skill in the art. It shouldtherefore be understood that the teachings below may be readilyincorporated into the various instruments taught in the variousreferences that are cited herein. It should also be understood that thebelow teachings are not limited to instrument (10) or devices taught inthe references cited herein. The below teachings may be readily appliedto various other kinds of instruments, including instruments that wouldnot be classified as surgical staplers. Various other suitable devicesand settings in which the below teachings may be applied will beapparent to those of ordinary skill in the art in view of the teachingsherein.

II. EXEMPLARY BUTTRESS ASSEMBLY FOR SURGICAL STAPLER

In some instances, it may be desirable to equip end effector (40) with abuttress material to reinforce the mechanical fastening of tissueprovided by staples (90). Such a buttress may prevent the appliedstaples (90) from pulling through the tissue and may otherwise reduce arisk of tissue tearing at or near the site of applied staples (90). Inaddition to or as an alternative to providing structural support andintegrity to a line of staples (90), a buttress may provide variousother kinds of effects such as spacing or gap-filling, administration oftherapeutic agents, and/or other effects. In some instances, a buttressmay be provided on deck (73) of staple cartridge (70). In some otherinstances, a buttress may be provided on the surface of anvil (60) thatfaces staple cartridge (70). It should also be understood that a firstbuttress may be provided on deck (73) of staple cartridge (70) while asecond buttress is provided on anvil (60) of the same end effector (40).Various examples of forms that a buttress may take will be described ingreater detail below. Various ways in which a buttress may be secured toa staple cartridge (70) or an anvil (60) will also be described ingreater detail below.

A. Exemplary Composition of Buttress Assembly for Surgical Stapler

FIG. 4 shows an exemplary pair of buttress assemblies (100, 110) with abasic composition. Buttress assembly (100) of this example comprises abuttress body (102) and an upper adhesive layer (104). Similarly,buttress assembly (110) comprises a buttress body (112) and a loweradhesive layer (114). In the present example, each buttress body (102,112) comprises a strong yet flexible material configured to structurallysupport a line of staples (90). By way of example only, each buttressbody (102, 112) may comprise a woven mesh of polyglactin 910 material byEthicon, Inc. of Somerville, N.J. Alternatively, any other suitablematerials or combinations of materials may be used in addition to or asan alternative to polyglactin 910 material to form each buttress body(102, 112). Each buttress body (102, 112) may take any other suitableform and may be constructed of any other suitable material(s). By way offurther example only, each buttress body (102, 112) may comprise one ormore of the following: NEOVEIL absorbable PGA felt by Gunze Limited, ofKyoto, Japan; SEAMGUARD polyglycolic acid:trimethylene carbonate(PGA:TMC) reinforcement material by W.L. Gore & Associates, Inc., ofFlagstaff, Ariz.; PERI-STRIPS DRY with VERITAS Collagen Matrix (PSDV)reinforcement material, by Baxter Healthcare Corporation of Deerfield,Ill.; BIODESIGN biologic graft material by Cook Medical, Bloomington,Ind.; and/or SURGICEL NU-KNIT hemostat material by Ethicon, Inc. ofSomerville, N.J. Still other suitable materials that may be used to formeach buttress body (102, 112) will be apparent to those of ordinaryskill in the art in view of the teachings herein.

In addition or in the alternative, each buttress body (102, 112) maycomprise a material including, for example, a hemostatic agent such asfibrin to assist in coagulating blood and reduce bleeding at the severedand/or stapled surgical site along tissue (90). As another merelyillustrative example, each buttress body (102, 112) may comprise otheradjuncts or hemostatic agents such as thrombin may be used such thateach buttress body (102, 112) may assist to coagulate blood and reducethe amount of bleeding at the surgical site. Other adjuncts or reagentsthat may be incorporated into each buttress body (102, 112) may furtherinclude but are not limited to medical fluid or matrix components.Merely illustrative examples of materials that may be used to form eachbuttress body (102, 112), as well as materials that may be otherwiseincorporated into each buttress body (102, 112), are disclosed in U.S.patent application Ser. No. 14/667,842, entitled “Method of Applying aButtress to a Surgical Stapler,” filed Mar. 25, 2015, the disclosure ofwhich is incorporated by reference herein. Alternatively, any othersuitable materials may be used.

By way of further example only, each buttress body (102, 112) may beconstructed in accordance with at least some of the teachings of U.S.Patent Pub. No. 2012/0241493, entitled “Tissue Thickness CompensatorComprising Controlled Release and Expansion,” published Sep. 27, 2012,the disclosure of which is incorporated by reference herein; U.S. PatentPub. No. 2013/0068816, entitled “Surgical Instrument and ButtressMaterial,” published Mar. 21, 2013, the disclosure of which isincorporated by reference herein; U.S. Patent Pub. No. 2013/0062391,entitled “Surgical Instrument with Fluid Fillable Buttress,” publishedMar. 14, 2013, the disclosure of which is incorporated by referenceherein; U.S. Patent Pub. No. 2013/0068820, entitled “Fibrin Pad Matrixwith Suspended Heat Activated Beads of Adhesive,” published Mar. 21,2013, the disclosure of which is incorporated by reference herein; U.S.Patent Pub. No. 2013/0082086, entitled “Attachment of Surgical StapleButtress to Cartridge,” published Apr. 4, 2013, the disclosure of whichis incorporated by reference herein; U.S. Patent Pub. No. 2013/0037596,entitled “Device for Applying Adjunct in Endoscopic Procedure,”published Feb. 14, 2013, the disclosure of which is incorporated byreference herein; U.S. Patent Pub. No. 2013/0062393, entitled “ResistiveHeated Surgical Staple Cartridge with Phase Change Sealant,” publishedMar. 14, 2013, the disclosure of which is incorporated by referenceherein; U.S. Patent Pub. No. 2013/0075446, entitled “Surgical StapleAssembly with Hemostatic Feature,” published Mar. 28, 2013, thedisclosure of which is incorporated by reference herein; U.S. PatentPub. No. 2013/0062394, entitled “Surgical Staple Cartridge withSelf-Dispensing Staple Buttress,” published Mar. 14, 2013, thedisclosure of which is incorporated by reference herein; U.S. PatentPub. No. 2013/0075445, entitled “Anvil Cartridge for Surgical FasteningDevice,” published Mar. 28, 2013, the disclosure of which isincorporated by reference herein; U.S. Patent Pub. No. 2013/0075447,entitled “Adjunct Therapy for Applying Hemostatic Agent,” published Mar.28, 2013, the disclosure of which is incorporated by reference herein;U.S. Patent Pub. No. 2013/0256367, entitled “Tissue ThicknessCompensator Comprising a Plurality of Medicaments,” published Oct. 3,2013, the disclosure of which is incorporated by reference herein; U.S.patent application Ser. No. 14/300,954, entitled “Adjunct Materials andMethods of Using Same in Surgical Methods for Tissue Sealing,” filedJun. 10, 2014, the disclosure of which is incorporated by referenceherein; U.S. patent application Ser. No. 14/827,856, entitled“Implantable Layers for a Surgical Instrument,” filed Aug. 17, 2015, thedisclosure of which is incorporated by reference herein; U.S. patentapplication Ser. No. 14/840,613, entitled “Drug Eluting Adjuncts andMethods of Using Drug Eluting Adjuncts,” filed Aug. 31, 2015, thedisclosure of which is incorporated by reference herein; U.S. patentapplication Ser. No. 14/871,071, entitled “Compressible Adjunct withCrossing Spacer Fibers,” filed Sep. 30, 2015, the disclosure of which isincorporated by reference herein; and/or U.S. patent application Ser.No. 14/871,131, entitled “Method for Applying an Implantable Layer to aFastener Cartridge,” field Sep. 30, 2015, the disclosure of which isincorporated by reference herein.

In the present example, adhesive layer (104) is provided on buttressbody (102) in order to adhere buttress body (102) to underside (65) ofanvil (60). Similarly, adhesive layer (114) is provided on buttress body(112) in order to adhere buttress body (112) to deck (73) of staplecartridge (70). Adherence of the buttress body (102) to underside (65)of anvil (60) or to deck (73) of staple cartridge (70) can occur througha variety of mechanisms including but not limited to a pressuresensitive adhesive. In some versions, each adhesive layer (104, 114)comprise a pressure sensitive adhesive material. Examples of varioussuitable materials that may be used to form adhesive layers (104, 114)are disclosed in U.S. patent application Ser. No. 14/667,842, entitled“Method of Applying a Buttress to a Surgical Stapler,” filed Mar. 25,2015, the disclosure of which is incorporated by reference herein.Alternatively, any other suitable materials may be used. It should beunderstood that the term “adhesive,” as used herein, may include (but isnot limited to) tacky materials and also materials that are pliable orwax-like and adhere to a complex geometry via deformation andconformance. Some suitable adhesives may provide such pliability toadhere to a complex geometry via deformation and conformance withoutnecessarily providing a high initial tack. In some instances, adhesiveswith lower tackiness may be removed more cleanly from surfaces. Varioussuitable materials that may be used to form adhesive layers (104, 114)will be apparent to those of ordinary skill in the art in view of theteachings herein.

B. Exemplary Materials and Techniques for Providing Adhesion of Buttressto Surgical Stapler

As noted above, a buttress assembly (100, 110) may include a layer (104,114) of adhesive material (or other form of adhesive material) thatadheres buttress body (102, 112) to either underside (65) of anvil (60)or deck (73) of staple cartridge (70). Such an adhesive material mayprovide proper positioning of buttress body (102, 112) before and duringactuation of end effector (40); then allow buttress body (102, 112) toseparate from end effector (40) after end effector (40) has beenactuated, without causing damage to buttress body (102, 112) that issubstantial enough to compromise the proper subsequent functioning ofbuttress body (102, 112).

FIGS. 5A-5C show a sequence where an end effector (40) that has beenloaded with buttress assemblies (100, 110) is actuated to drive staples(90) through two apposed layers of tissue (T₁, T₂), with buttressassemblies (100, 110) being secured to the same layers of tissue (T₁,T₂) by staples (90). In particular, FIG. 5A shows layers of tissue (T₁,T₂) positioned between anvil (60) and staple cartridge (70), with anvil(60) in the open position. Buttress assembly (100) is adhered to theunderside (65) of anvil (60) via adhesive layer (104); while buttressassembly (110) is adhered to deck (73) of staple cartridge (70) viaadhesive layer (114). Layers of tissue (T₁, T₂) are thus interposedbetween buttress assemblies (100, 110). Next, trigger (24) is pivotedtoward pistol grip (22) to drive closure tube (32) and closure ring (36)distally. This drives anvil (60) to the closed position as shown in FIG.5B. At this stage, layers of tissue (T₁, T₂) are compressed betweenanvil (60) and staple cartridge (70), with buttress assemblies (100,110) engaging opposite surfaces of tissue layers (T₁, T₂). End effector(40) is then actuated as described above, driving staple (90) throughbuttress assemblies (100, 110) and tissue (90). As shown in FIG. 5C,crown (92) of driven staple (90) captures and retains buttress assembly(110) against layer of tissue (T₂). Deformed legs (94) of staple (90)capture and retain buttress assembly (100) against layer of tissue (T₁).

It should be understood that a series of staples (90) will similarlycapture and retain buttress assemblies (100, 110) against layers oftissue (T₁, T₂), thereby securing buttress assemblies (100, 110) totissue (T₁, T₂) as shown in FIG. 6. As end effector (40) is pulled awayfrom tissue (90) after deploying staples (90) and buttress assemblies(100, 110), buttress assemblies (100, 110) disengage end effector), suchthat buttress assemblies (100, 110) remain secured to tissue (T₁, T₂)with staples (90). Buttress tissue (T₁, T₂) thus provide structuralreinforcement to the lines of staples (90). As can also be seen in FIG.6, knife member (80) also cuts through a centerline of buttress tissueassemblies (100, 110), separating each buttress assemblies (100, 110)into a corresponding pair of sections, such that each section remainssecured to a respective severed region of tissue (T₁, T₂).

In the foregoing example, buttress assembly (100) is sized to spanacross the full width of underside (65), such that buttress assembly(100) spans across channel (62). Thus, knife member (80) cuts throughbuttress assembly (100) during actuation of end effector (40) asdescribed above. In some other examples, such as those described below,buttress assembly (100) is provided in two separate, laterally spacedapart portions, with one portion being disposed on underside (65) on oneside of channel (62) and another portion being disposed on underside(65) on the other side of channel (62). In such versions, buttressassembly (100) does not span across channel (62), such that knife member(80) does not cut through buttress assembly (100) during actuation ofend effector (40).

Likewise, buttress assembly (110) may be sized to span across the fullwidth of deck (73), such that buttress assembly (110) spans acrosschannel (72), and such that knife member (80) cuts through buttressassembly (110) during actuation of end effector (40) as described above.Alternatively, buttress assembly (110) may be provided in two separate,laterally spaced apart portions, with one portion being disposed on deck(73) on one side of channel (72) and another portion being disposed ondeck (73) on the other side of channel (72), such that buttress assembly(110) does not span across channel (72), and such that knife member (80)does not cut through buttress assembly (110) during actuation of endeffector (40).

III. EXEMPLARY MULTI-LAYER ADHESIVE ARRANGEMENT FOR BUTTRESS ASSEMBLY

In some instances, it may be desirable to provide a version of abuttress assembly (100, 110) where adhesive layer (104, 114) comprisestwo or more layers of different kinds of adhesive material havingdifferent properties. For instance, FIGS. 7-8 show an exemplary buttressassembly (200) that comprises a buttress body (202), a first adhesivelayer (204) laid over buttress body (202), and a second adhesive layer(206) laid over first adhesive layer (204). It should be understoodthat, with buttress body (202) at the bottom of buttress assembly (200),buttress assembly (200) is analogous to buttress assembly (100)described above and may be similarly secured to underside (65) of anvil(60). Alternatively, buttress assembly (200) may be flipped upside-downfor an arrangement where buttress assembly (200) would be secured todeck (73) of staple cartridge (70). In such versions, second adhesivelayer (206) would be at the bottom, first adhesive layer (204) would belaid over second adhesive layer (206), and buttress body (202) would belaid over first adhesive layer (204).

Buttress body (202) may be constructed and operable just like buttressbodies (102, 112) described above. Moreover, buttress body (202) may beconstructed and operable in accordance with at least some of theteachings of U.S. patent application Ser. No. 14/667,842, entitled“Method of Applying a Buttress to a Surgical Stapler,” filed Mar. 25,2015, the disclosure of which is incorporated by reference herein. Othersuitable forms that buttress body (202) may take will be apparent tothose of ordinary skill in the art in view of the teachings herein.

First adhesive layer (204) is formed of an adhesive material that isdifferent from the adhesive material forming second adhesive layer(206). In some versions, first adhesive layer (204) is formed of amaterial that has greater pliability and tackiness than the materialforming second adhesive layer (206). In some such versions, secondadhesive layer (206) serves as a protectant for first adhesive layer(204). For instance, second adhesive layer (206) may protect firstadhesive layer (204) from humidity, temperature fluctuations, and/orother environmental conditions that may be encountered during shipmentand/or storage of buttress assembly (200). In other words, secondadhesive layer (206) may be more resistant to moisture and/ortemperature than first adhesive layer (206). In some other variations,second adhesive layer (206) is replaced with a non-adhesive protectivelayer. By way of example only, second adhesive layer (206) may bereplaced by a film or other structure that is biocompatible andbioabsorbable, dissolvable, or otherwise capable of temporarilyconfining the material forming first adhesive layer (204) (e.g., toprevent first adhesive layer from seeping, migrating, or otherwiseflowing out of buttress assembly (200) during storage, shipping,handling before surgery, etc.). When anvil (60) is pressed againstbuttress assembly (200) both adhesive layers (204, 206) may neverthelesscooperate to adhere buttress assembly (200) to underside (65) of anvil(60).

In some versions, second adhesive layer (206) is sprayed onto firstadhesive layer (204) while first adhesive layer is maintained at atemperature and humidity level that keeps first adhesive layer (204)solid. It should be understood that the combination of differentadhesive layers (204, 206) may be more soluble against anvil (60) and/orless sticky against anvil (60) than just a single adhesive layer (204)might be. This may prevent an undesirable buildup of adhesive materialon underside (65) of anvil (60) as a series of buttress assemblies (200)are applied to underside (65) for a series of end effector (40)actuations during a surgical procedure. It should also be understoodthat adhesive layers (204, 206) may provide different ratios of twomolecular weight blends in different layers (204, 206). In addition,adhesive layers (204, 206) may have cross-linking differences and/orcome from different families of adhesive. By way of further exampleonly, adhesive layers (204, 206) formed by higher molecular weightpoloxamers may be stiffer and less prone to flow with temperature. Thus,using a poloxamer blend with higher molecular weight to form adhesivelayer (206) may contain a lower molecular weight material formingadhesive layer (204), even if adhesive layer (204) becomes fluid withtemperature. Materials with higher degrees of cross-linking may havehigher transition temperatures and therefore flow less at temperatureextremes. An example of different families could be a poloxamer blend inadhesive layer (204) with a thin layer of PCL/PGA co-ploymer sprayedonto adhesive layer (204) to form adhesive layer (206).

Various suitable materials that may be used to form second adhesivelayer (206) and non-adhesive substitutes for second adhesive layer willbe apparent to those of ordinary skill in the art in view of theteachings herein. By way of example only, first adhesive layer (204) maybe configured and operable in accordance with at least some of theteachings of U.S. patent application Ser. No. ______ [ATTORNEY DOCKETNO. END7809USNP.0630312], entitled “Surgical Stapler Buttress Assemblywith Humidity Tolerant Adhesive,” filed on even date herewith, thedisclosure of which is incorporated by reference herein; U.S. patentapplication Ser. No. ______ [ATTORNEY DOCKET NO. END7810USNP.0630307],entitled “Surgical Stapler Buttress Assembly with Adhesion to Wet EndEffector,” filed on even date herewith, the disclosure of which isincorporated by reference herein; and/or any other references citedherein.

In buttress assembly (200), the outer edges of first adhesive layer(204) are left exposed by second adhesive layer (206). FIGS. 9-10 showan exemplary alternative buttress assembly (300) where the outer edgesof a first adhesive layer (304) are covered by downwardly projectingregions (308) of a second adhesive layer (306). Downwardly projectingregions (308) extend along the full width and the full length of firstadhesive layer (304) in this example. Downwardly projecting regions(308) also extend downwardly into contact with the upper surface ofbuttress body (302). Buttress body (302) and second adhesive layer (306)thus cooperate to completely encapsulate first adhesive layer (304).Buttress body (302), first adhesive layer (304), and second adhesivelayer (306) may be otherwise identical to buttress body (202), firstadhesive layer (204), and second adhesive layer (206) as describedabove. Other suitable ways in which adhesive layers (304, 306) may beconfigured and arranged in relation to a buttress body (302) will beapparent to those of ordinary skill in the art in view of the teachingsherein.

In addition to the foregoing, it should also be understood that any ofthe various buttress assemblies described herein may be furtherconstructed and operable in accordance with at least some of theteachings of U.S. patent application Ser. No. 14/667,842, entitled“Method of Applying a Buttress to a Surgical Stapler,” filed Mar. 25,2015, the disclosure of which is incorporated by reference herein.

IV. EXEMPLARY COMBINATIONS

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

A surgical stapler end effector assembly, the end effector assemblycomprising: (a) a staple cartridge, wherein the staple cartridgecomprises: (i) a plurality of staples, and (ii) a deck, wherein thestaple cartridge is operable to drive the staples through the deck; (b)an anvil, wherein the anvil is movable from an open position toward thestaple cartridge to reach a closed position, wherein the anvil includesan underside having a staple forming surface configured to receivestaples driven through the deck; and (c) a buttress assembly, whereinthe buttress assembly is sized and configured to be coupled with thedeck of the staple cartridge or the underside of the anvil, wherein thebuttress assembly comprises: (i) a buttress body, (ii) a first adhesivelayer laid over the buttress body, wherein the first adhesive layer isformed of a first adhesive material, and (iii) a second adhesive layerlaid over the first adhesive layer, such that the first adhesive layeris interposed between the second adhesive layer and the buttress body,wherein the second adhesive layer is formed of a second adhesivematerial, wherein the second adhesive material is different from thefirst adhesive material.

Example 2

The end effector assembly of Example 1, wherein the second adhesivelayer is positioned to face the underside of the anvil.

Example 3

The end effector assembly of any one or more of Examples 1 through 2,wherein the second adhesive layer is positioned to face the deck of thestaple cartridge.

Example 4

The end effector assembly of any one or more of Examples 1 through 3,wherein the first adhesive material has greater pliability than thesecond adhesive material.

Example 5

The end effector assembly of any one or more of Examples 1 through 4,wherein the first adhesive material has greater tackiness than thesecond adhesive material.

Example 6

The end effector assembly of any one or more of Examples 1 through 5,wherein the second adhesive material is more resistant to moisture thanthe first adhesive material.

Example 7

The end effector assembly of any one or more of Examples 1 through 6,wherein the second adhesive material is more resistant to temperaturethan the first adhesive material.

Example 8

The end effector assembly of any one or more of Examples 1 through 7,wherein the first and second adhesive layers are configured to cooperateto adhere the buttress body to either the deck of the staple cartridgeor the underside of the anvil.

Example 9

The end effector assembly of any one or more of Examples 1 through 8,wherein the first and second adhesive materials have different molecularweight blends.

Example 10

The end effector assembly of any one or more of Examples 1 through 9,wherein the first and second adhesive materials have differentcross-linking properties.

Example 11

The end effector assembly of any one or more of Examples 1 through 10,wherein the first and second adhesive materials are selected fromdifferent families of adhesive materials.

Example 12

The end effector assembly of any one or more of Examples 1 through 11,wherein the second adhesive material comprises regions contacting thebuttress body.

Example 13

The end effector assembly of Example 12, wherein the buttress body andthe regions of the second adhesive material contacting the buttress bodycooperate to encapsulate the first adhesive material.

Example 14

The end effector assembly of any one or more of Examples 12 through 13,wherein the first adhesive layer has a length, wherein the regions ofthe second adhesive material contacting the buttress body extend alongthe full length of the first adhesive layer.

Example 15

The end effector assembly of any one or more of Examples 12 through 14,wherein the first adhesive layer has a width, wherein the regions of thesecond adhesive material contacting the buttress body extend along thefull width of the first adhesive layer.

Example 16

The end effector assembly of any one or more of Examples 1 through 15,wherein the buttress assembly is adhered to the underside of the anvil,wherein the staples are positioned to be driven through the buttressassembly.

Example 17

A surgical stapler end effector assembly, the end effector assemblycomprising: (a) a lower jaw; (b) an anvil, wherein the anvil is movablefrom an open position toward the lower jaw to reach a closed position,wherein the anvil includes an underside having a staple forming surface;and (c) a buttress assembly secured to the underside of the anvil,wherein the buttress assembly comprises: (i) a buttress body, (ii) afirst adhesive layer laid over the buttress body, wherein the firstadhesive layer is formed of a first adhesive material, and (iii) asecond adhesive layer laid over the first adhesive layer, such that thefirst adhesive layer is interposed between the second adhesive layer andthe buttress body, wherein the second adhesive layer is formed of asecond adhesive material, wherein the second adhesive material isdifferent from the first adhesive material.

Example 19

A method of making a buttress assembly for use with a surgical staplerend effector, wherein the end effector comprises a staple cartridge andan anvil, wherein the staple cartridge comprises a plurality of staplesand a deck, wherein the staple cartridge is operable to drive thestaples through the deck, wherein the anvil is movable from an openposition toward the staple cartridge to reach a closed position, whereinthe anvil includes an underside having a staple forming surfaceconfigured to receive staples driven through the deck, the methodcomprising: (a) applying a first adhesive layer to a buttress body,wherein the buttress body is sized and configured to fit on the deck ofthe staple cartridge or the underside of the anvil, wherein the firstadhesive layer comprises a first adhesive material; and (b) applying asecond adhesive layer to the first adhesive layer, such that the firstadhesive layer is interposed between the second adhesive layer and thebuttress body, wherein the second adhesive layer is formed of a secondadhesive material, wherein the second adhesive material is differentfrom the first adhesive material.

Example 19

The method of Example 18, wherein the act of applying the secondadhesive layer to the first adhesive layer comprises spraying the secondadhesive layer over the first adhesive layer.

Example 20

The method of any one or more of Examples 18 through 19, furthercomprising pressing the buttress assembly against the underside of theanvil, wherein one or both of the first or second adhesive materialssecures the buttress assembly to the underside of the anvil in responseto pressing the buttress assembly against the underside of the anvil.

V. MISCELLANEOUS

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

In addition to the foregoing, it should also be understood that any ofthe various buttress assemblies described herein may be furtherconstructed and operable in accordance with at least some of theteachings of U.S. patent application Ser. No. 14/667,842, entitled“Method of Applying a Buttress to a Surgical Stapler,” filed Mar. 25,2015, the disclosure of which is incorporated by reference herein; U.S.patent application Ser. No. 14/827,856, entitled “Implantable Layers fora Surgical Instrument,” filed Aug. 17, 2015, the disclosure of which isincorporated by reference herein; U.S. patent application Ser. No.14/871,071, entitled “Compressible Adjunct with Crossing Spacer Fibers,”filed Sep. 30, 2015, the disclosure of which is incorporated byreference herein; and U.S. patent application Ser. No. 14/871,131,entitled “Method for Applying an Implantable Layer to a FastenerCartridge,” field Sep. 30, 2015, the disclosure of which is incorporatedby reference herein. Furthermore, in addition to the methods describedherein, any of the various buttress assemblies described herein may beapplied to end effector (40) in accordance with at least some of theteachings of U.S. Provisional Patent App. No. 62/209,041, entitled“Method and Apparatus for Applying a Buttress to End Effector of aSurgical Stapler,” filed Aug. 24, 2015, the disclosure of which isincorporated by reference herein; and/or U.S. patent application Ser.No. 14/871,131, entitled “Method for Applying an Implantable Layer to aFastener Cartridge,” field Sep. 30, 2015, the disclosure of which isincorporated by reference herein. Various suitable ways in which theteachings herein may be combined with various teachings of theabove-cited references will be apparent to those of ordinary skill inthe art.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof any of the following: U.S. Pat. No. 5,792,135, entitled “ArticulatedSurgical Instrument For Performing Minimally Invasive Surgery WithEnhanced Dexterity and Sensitivity,” issued Aug. 11, 1998, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.5,817,084, entitled “Remote Center Positioning Device with FlexibleDrive,” issued Oct. 6, 1998, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,878,193, entitled “Automated EndoscopeSystem for Optimal Positioning,” issued Mar. 2, 1999, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,231,565,entitled “Robotic Arm DLUS for Performing Surgical Tasks,” issued May15, 2001, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with UltrasoundCauterizing and Cutting Instrument,” issued Aug. 31, 2004, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.6,364,888, entitled “Alignment of Master and Slave in a MinimallyInvasive Surgical Apparatus,” issued Apr. 2, 2002, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,524,320,entitled “Mechanical Actuator Interface System for Robotic SurgicalTools,” issued Apr. 28, 2009, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,691,098, entitled “Platform Link WristMechanism,” issued Apr. 6, 2010, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,806,891, entitled “Repositioningand Reorientation of Master/Slave Relationship in Minimally InvasiveTelesurgery,” issued Oct. 5, 2010, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2013/0012957, entitled“Automated End Effector Component Reloading System for Use with aRobotic System, published Jan. 10, 2013, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0199630, entitled“Robotically-Controlled Surgical Instrument with Force-FeedbackCapabilities,” published Aug. 9, 2012, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0132450, entitled“Shiftable Drive Interface for Robotically-Controlled Surgical Tool,”published May 31, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0199633, entitled “SurgicalStapling Instruments with Cam-Driven Staple Deployment Arrangements,”published Aug. 9, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0199631, entitled“Robotically-Controlled Motorized Surgical End Effector System withRotary Actuated Closure Systems Having Variable Actuation Speeds,”published Aug. 9, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0199632, entitled“Robotically-Controlled Surgical Instrument with SelectivelyArticulatable End Effector,” published Aug. 9, 2012, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0203247,entitled “Robotically-Controlled Surgical End Effector System,”published Aug. 9, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0211546, entitled “Drive Interfacefor Operably Coupling a Manipulatable Surgical Tool to a Robot,”published Aug. 23, 2012; U.S. Pub. No. 2012/0138660, entitled“Robotically-Controlled Cable-Based Surgical End Effectors,” publishedJun. 7, 2012, the disclosure of which is incorporated by referenceherein; and/or U.S. Pub. No. 2012/0205421, entitled“Robotically-Controlled Surgical End Effector System with RotaryActuated Closure Systems,” published Aug. 16, 2012, the disclosure ofwhich is incorporated by reference herein.

Versions of the devices described above may be designed to be disposedof after a single use, or they can be designed to be used multipletimes. Versions may, in either or both cases, be reconditioned for reuseafter at least one use. Reconditioning may include any combination ofthe steps of disassembly of the device, followed by cleaning orreplacement of particular pieces, and subsequent reassembly. Inparticular, some versions of the device may be disassembled, and anynumber of the particular pieces or parts of the device may beselectively replaced or removed in any combination. Upon cleaning and/orreplacement of particular parts, some versions of the device may bereassembled for subsequent use either at a reconditioning facility, orby a user immediately prior to a procedure. Those skilled in the artwill appreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

I/We claim:
 1. A surgical stapler end effector assembly, the endeffector assembly comprising: (a) a staple cartridge, wherein the staplecartridge comprises: (i) a plurality of staples, and (ii) a deck,wherein the staple cartridge is operable to drive the staples throughthe deck; (b) an anvil, wherein the anvil is movable from an openposition toward the staple cartridge to reach a closed position, whereinthe anvil includes an underside having a staple forming surfaceconfigured to receive staples driven through the deck; and (c) abuttress assembly, wherein the buttress assembly is sized and configuredto be coupled with the deck of the staple cartridge or the underside ofthe anvil, wherein the buttress assembly comprises: (i) a buttress body,(ii) a first adhesive layer laid over the buttress body, wherein thefirst adhesive layer is formed of a first adhesive material, and (iii) asecond adhesive layer laid over the first adhesive layer, such that thefirst adhesive layer is interposed between the second adhesive layer andthe buttress body, wherein the second adhesive layer is formed of asecond adhesive material, wherein the second adhesive material isdifferent from the first adhesive material.
 2. The end effector assemblyof claim 1, wherein the second adhesive layer is positioned to face theunderside of the anvil.
 3. The end effector assembly of claim 1, whereinthe second adhesive layer is positioned to face the deck of the staplecartridge.
 4. The end effector assembly of claim 1, wherein the firstadhesive material has greater pliability than the second adhesivematerial.
 5. The end effector assembly of claim 1, wherein the firstadhesive material has greater tackiness than the second adhesivematerial.
 6. The end effector assembly of claim 1, wherein the secondadhesive material is more resistant to moisture than the first adhesivematerial.
 7. The end effector assembly of claim 1, wherein the secondadhesive material is more resistant to temperature than the firstadhesive material.
 8. The end effector assembly of claim 1, wherein thefirst and second adhesive layers are configured to cooperate to adherethe buttress body to either the deck of the staple cartridge or theunderside of the anvil.
 9. The end effector assembly of claim 1, whereinthe first and second adhesive materials have different molecular weightblends.
 10. The end effector assembly of claim 1, wherein the first andsecond adhesive materials have different cross-linking properties. 11.The end effector assembly of claim 1, wherein the first and secondadhesive materials are selected from different families of adhesivematerials.
 12. The end effector assembly of claim 1, wherein the secondadhesive material comprises regions contacting the buttress body. 13.The end effector assembly of claim 12, wherein the buttress body and theregions of the second adhesive material contacting the buttress bodycooperate to encapsulate the first adhesive material.
 14. The endeffector assembly of claim 12, wherein the first adhesive layer has alength, wherein the regions of the second adhesive material contactingthe buttress body extend along the full length of the first adhesivelayer.
 15. The end effector assembly of claim 12, wherein the firstadhesive layer has a width, wherein the regions of the second adhesivematerial contacting the buttress body extend along the full width of thefirst adhesive layer.
 16. The end effector assembly of claim 1, whereinthe buttress assembly is adhered to the underside of the anvil, whereinthe staples are positioned to be driven through the buttress assembly.17. A surgical stapler end effector assembly, the end effector assemblycomprising: (a) a lower jaw; (b) an anvil, wherein the anvil is movablefrom an open position toward the lower jaw to reach a closed position,wherein the anvil includes an underside having a staple forming surface;and (c) a buttress assembly secured to the underside of the anvil,wherein the buttress assembly comprises: (i) a buttress body, (ii) afirst adhesive layer laid over the buttress body, wherein the firstadhesive layer is formed of a first adhesive material, and (iii) asecond adhesive layer laid over the first adhesive layer, such that thefirst adhesive layer is interposed between the second adhesive layer andthe buttress body, wherein the second adhesive layer is formed of asecond adhesive material, wherein the second adhesive material isdifferent from the first adhesive material
 18. A method of making abuttress assembly for use with a surgical stapler end effector, whereinthe end effector comprises a staple cartridge and an anvil, wherein thestaple cartridge comprises a plurality of staples and a deck, whereinthe staple cartridge is operable to drive the staples through the deck,wherein the anvil is movable from an open position toward the staplecartridge to reach a closed position, wherein the anvil includes anunderside having a staple forming surface configured to receive staplesdriven through the deck, the method comprising: (a) applying a firstadhesive layer to a buttress body, wherein the buttress body is sizedand configured to fit on the deck of the staple cartridge or theunderside of the anvil, wherein the first adhesive layer comprises afirst adhesive material; and (b) applying a second adhesive layer to thefirst adhesive layer, such that the first adhesive layer is interposedbetween the second adhesive layer and the buttress body, wherein thesecond adhesive layer is formed of a second adhesive material, whereinthe second adhesive material is different from the first adhesivematerial.
 19. The method of claim 18, wherein the act of applying thesecond adhesive layer to the first adhesive layer comprises spraying thesecond adhesive layer over the first adhesive layer.
 20. The method ofclaim 18, further comprising pressing the buttress assembly against theunderside of the anvil, wherein one or both of the first or secondadhesive materials secures the buttress assembly to the underside of theanvil in response to pressing the buttress assembly against theunderside of the anvil.